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Events Calendar

APRIL - JUNE 2006
NEWSLETTER

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New staff:

We are pleased to announce the addition of a new staff member Ms. Jamie Miller. She has worked with us in the recent past when we were in desperate need of help to get the February & March FTC information request processed and out the door. She proved herself to be a hard worker with a great deal of administrative and computer skills, and the ability to focus on and complete projects as assigned. Initially, she will be approximately ½ time bringing our total staff to 3.5 FTEs which is still quite lean given the volume of work we do.

Her main job duties will be assisting Paula Soine with her HCAHPS survey and assisting with some of Paula’s other duties so she can spend more hands on time with the HCAHPS surveys. Other duties Jamie will work on include helping Chuck Ness with synchronizing our member/provider lists with our various health plans and helping with pharmacy contracting. 

Help us welcome her to MRHC. Her e-mail is jmiller@mrhc.net and phone is 320-564-9118 ext 14.

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Computer purchase opportunity:

We have negotiated a group discount of about $1,400 for a new type of personal computer that we believe would be particularly beneficial to our membership. We had a demo computer at our January 2006 CME event. The great thing about this computer is that it really opens up your desk area if you are short of space, and most of our members are. With this computer there is no box beside the monitor or under your desk nor are you saddled with the small keyboard, and no number pad or ten-key, of a laptop. This is a high end computer with all the hardware, including hard disk and CD/DVD, mounted behind the screen. The computer is 2.2 inches deep.

“The MPC ClientPro 414—our favorite space-saving system—comes in a sleek all-in-one design and has enough horsepower to drive demanding applications. Get back that valuable office real estate without giving up the comfort of a full-featured, powerful computer.” GCN review April 2005 see at: http://www.gcn.com/print/24_8/35520-1.html.

Let us know if you are interested. The higher the quantity, the better the deal.

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Federal Trade Commission (FTC):

As people may recall we received notice of an FTC inquiry regarding pharmacy membership class July 19th, 2005. At that time we responded with information they requested. After some review the FTC requested additional information from us and our pharmacy members and invited me to come to Washington DC for an interview on March 14^th, 2006. Following the interview they asked us for additional information that we will be providing to them shortly. We will continue to provide them information in the future as they request it.

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Senator Coleman listening session March 22:

Chuck Ness was one, and Mark Paulson of the Chippewa County Montevideo Hospital was another, of a five member panel that Sen. Norm Coleman invited to a rural health care listening session in Montevideo March 22^nd.

Mr. Paulson used his time to discuss issues that impact his Critical Access Hospital and clinic entity. Mr. Ness touched on several items that impact his many constituencies including: 1) Critical Access Hospitals and Medicare Advantage contracting and reimbursement concerns; 2) clinics with stagnant Medicare reimbursement for the past five+ years; 3) pharmacies being devastated by Medicare part D and concerns for what Medicaid will bring in 2007; 4) request for help with HIT & EMR oriented federal grants; and 5) request for federal pre-emption for small rural health plan demonstration projects. There was a lot of information shared by the panelists and Sen. Coleman seemed quite engaged. He even promised to follow-up with our concerns with UniCare and their poor provider support.

There was also a lot of interesting questions and concerns from the audience that I would number at about 60 – 80 people. Most notable were two regional pharmacists that discussed their concerns with Medicare Part D and how it may put them out of business.

Mr. Ness will be following up with Sen. Coleman’s office regarding various pharmacy issues during the month of April. Whether or not Sen. Coleman is able to favorably impact our members’ situations it is encouraging that he took the time to come to hear our information and concerns. It’s not often we get the ear, however fleetingly, of a US Senator.   

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Visit our website for meeting times and places at www.mrhc.net.

If you need a user ID and password,

please contact Paula Soine

at (320) 564-9118 (ext. 12) or psoine@mrhc.net.


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Minnesota Rural Health Cooperative Meeting Schedule

• April 5 Medi-Sota Board meeting Montevideo
• April 6 3^rd Annual SWEPT Conference Morton
• April 11 Pharmacy teleconference 7:30pm
• April 12 Pharmacy Contracting teleconference
• April 13 WCHPA meeting Benson
• April 17 Credentials teleconference
• April 19 Pharmacy Contracting teleconference
• April 19   Quality Council Quarterly meet Monte
• April 21 Contracting Committee meeting
• April 26 Pharmacy Contracting teleconference
• April 26 SWEPT meeting Marshall
• April 27 Compliance Quarterly meeting Monte
• April 27 Board of Directors meeting GF
   
• May 3 Pharmacy Contracting teleconference
• May 10 Pharmacy Contracting teleconference
• May 11 Contracting Committee meet Willmar
• May 15 Credentials teleconference
• May 17 Pharmacy Contracting Teleconference
• May 18 MRHC Annual Meeting Granite
• May 24 SWEPT meeting Marshall
• May 24 MediSota Annual Planning Retreat
   
• June 7 Pharmacy Contracting teleconference
• June 8 Contracting Committee meet Willmar
• June 14 Pharmacy Contracting teleconference
• June 19 Credentials teleconference
• June 21 Pharmacy Contracting teleconference
• June 22 Board of Directors meeting Granite
• June 28 Pharmacy Contracting teleconference
• June 28 SWEPT meeting Marshall
   
• July 5 Pharmacy Contracting teleconference
• July 12  Pharmacy Contracting teleconference
• July 13 Contracting Committee meet Willmar
• July 19 Pharmacy Contracting teleconference
• July 19 Quality Council Quarterly meet Monte
• July 24 Credentials teleconference
• July 24 Pharmacy Contracting teleconference
• July 26  SWEPT meeting Marshall
• July 27 Clinic Managers meeting
• July 27 Board of Directors meeting Granite
   

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2006 Board Members (thru May 18, 2006)

Brendon Cullinan, M.D., CCMH Montevideo Clinic - Chair

Larry Grong, D.O., Lac qui Parle Clinic– Vice Chair

James Schulte, Administrator, Redwood Area Hospital  - Secretary

Glenn Haugo, Administrator, Johnson Memorial Health Services - Treasurer                       

George Gordon, M.D., Rice Memorial Hospital

Mark Huntington, M.D., Northside Medical Center

Romulo Kabatay, M.D., Appleton Clinic

David Koster, Pharmacist, Koster Pharmacy -Tyler

Dale Kruger, Administrator, Tyler Healthcare Center

Richard Mulder, M.D., Ivanhoe Clinic

Tom Richter, Administrator, Madison Hospital

Alan Roiseland M.D., Family Practice Medical Center-Willmar

Thomas Witt, Pharmacist, Witt’s Pharmacy -Rushford

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Clinic, Hospital & Pharmacy Contracting: Due to the confidential nature of MRHC contracts with the various health providers and PBMs, we can’t put contract negotiation information on this website.  Please contact the MRHC office for this information.

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Pharmacy issues:

At 7:30pm Tuesday April 11^th we will be having our first pharmacy group teleconference to discuss various issues with pharmacy members that call in. During this one hour teleconference we will: FTC & Senator Coleman update; where we stand financially as a member class given the FTC related expenses and other activities; the buying group project; the drug card project; and if there is time, potential consulting services.

FTC & Sen. Coleman issues mentioned above.

Pharmacy class financials. The intention is that the pharmacy class will pay its own way primarily through dues for expenses that can be traced directly to their membership class. Unfortunately, the majority of our expenses since the April 2005 start date of the pharmacy class have been legal fees. Rest assured that we feel have budgeted a LOT of money for 2006 for Consulting & Legal fees. We have about $5,500 carried over from 2005 and so far we have $70,000 budgeted for Consulting & Legal and we have so far spent $20,000 including the March 14, 2006 Washington DC expenses. We feel we are in very good shape and have a significant cushion, roughly $55,000, to work with.

Buying Group: We are working with Astrup Drug regarding accessing their buying group and many potential benefits for our membership.

Drug Card: We are working with a drug discount card processor to develop the MRHC discount card. The idea here will be to get “our card” in the hands of our patients before someone else does so we can get the downstream benefits instead of someone else. We also feel that this would provide experience that will be invaluable for other potential projects.

Pharmacy business consulting. We are developing a consulting service utilizing current and retired pharmacists that will, for a very low fee, review your operation to see if there are ways to improve your business. This has not yet been fully developed but we intend for it to be very affordable and a great value.

The call in info is toll free dial in 1-877-322-9648 with participant code of 524905. If need be we can schedule a follow-up teleconference at a later date.

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More on HCAHPS…

HCAHPS stands for “Hospital Consumer Assessment of Healthcare Providers and Systems.” Its purpose is to uniformly measure and publicly report patients’ perspectives on their inpatient care and only meant for short-term, acute care hospitals.

The MRHC is one of 45 survey vendors for the HCAHPS surveys across the nation, and is one of only two based in Minnesota. CMS anticipates most hospitals will use a survey vendor.

Hospitals that wish to publicly report MUST participate in the Dry Run. The Dry Run, previously was set to occur only in April and May, has been extended through June for the October 2006 National Implementation, with public reporting data first to appear in late 2007.  If your facility would like to participate in the HCAHPS process, it is not too late: the Dry Run is April OR May OR June – one, two, or all three months.

Hospitals who do not participate in the April, May, or June 2006 Dry Run must wait until the 2007 Dry Run to participate in HCAHPS, with that public reporting data to first appear in late 2008.

Hospitals will have a 30-day preview of the HCAHPS results, allowing hospitals the option to opt out of public reporting their data.

Currently there are no financial incentives to public reporting. However, all the information I have received on HCAHPS ends with “if in the future HCAHPS is linked to pay-for-reporting.” Where there’s smoke there’s fire….

Any profits garnered from the administration of this survey are returned to MRHC members.

For more information visit : www.hcahpsonline.org

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HIT TIDBITS

With all but the final grant report written, the HIT Planning grant is officially at an end. Or has it just begun? We’d like to think that the information we have provided to you from this endeavor proves to be valuable to you as your facility considers or advances in its EHR initiative.

I made the offer once before and have sent out a number of them, but if anyone would like a burned CD which contains, among other things, the RFP’s we sent out to the clinic and hospital vendors, the vendor analysis that Valor Solutions did on the vendors and their products, the attendee evaluation summaries from the four clinic and four hospital Vendor Demonstration Days, and cost benefit worksheets, please let Paula know.

We also want to say again that we consider the work that Valor Solutions did in their vendor analysis for this project top notch. Should any of you wish to use their services for your facility’s EHR pursuits, they can be contacted at:

Stan Hunecke, Shunecke@charter.net , 612.760.1293

Bill Sonterre, billsonterre@aol.com , 651.334.6285

Meanwhile, we continue to wait for word on our Rural Health Network Development Grant application. Final funding decisions should be made between April 15 and May 1. And we are patiently waiting for the USDA grant application to open up. We’ve been hearing “any day now” for the last four months….

There may be good news on the Health Information Technology forefront for MRHC facilities. When Senator Coleman was in our area recently, he spoke about his drive to have more technology assistance grants available for Critical Access hospitals. And Governor Pawlenty is proposing $12 million to be set aside for small/rural EHR investments. Of course, we will keep you posted on any concrete developments, but things we have unofficially heard about his proposal are that grant projects must:

The MRHC Annual Shareholder’s Meeting

is set for

Thursday, May 18^th, 2006

6:15 p.m.

at

Prairie’s Edge Convention Center

Granite Falls

Physicians, Hospital Administrators, Clinic Managers,

Pharmacists, Committee Representatives,

Facility Board Members, and Spouses

are invited to attend

Call in your RSVP before May 8^th

to Sandy at (320) 564-9118 x10

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CME Wrap-Up

“Small, intimate setting was very conducive to learning.”

“Excellent variety of topics – much broader perspective than most conferences and presentations were excellent.”

“Facilities were excellent – I would definitely return.”

“It is an excellent conference and great to be local.”

“It keeps getting better each year!”

These were among the very positive comments the MRHC has received on our 2^nd Annual Education Conference, held January 20^th & 21st at Prairie’s Edge Convention Center in Granite Falls.  The number of contact hours and CME credits grew by 33%, with attendance growing by 24% over last year’s conference, the increase coming from LPN’s, RMA’s, pharmacists and other non-physicians.  Sponsorship of the conference increased by almost 50%, also, as the number of vendor booths increased from 9 to 17, with a few vendors making contributions for not only booths but for specific meals and prize drawings for attendees, something new we added this year.  Prize drawings were a Canon Sure Shot digital camera, a palm pilot PDA, and three USB zip drives.  They were a definite hit and we plan to increase the number of prizes for the next conference, which has been set for Friday and Saturday, January 19^th and 20^th, 2007. We will be dividing the hours to better accommodate our participants and vendors. Plans (pending) thus far are to have 3 presentations Friday afternoon/early evening and 6 presentations on Saturday morning/afternoon ending by 5:00 PM.

All presentations given at this year’s convention received “excellent” reviews and were certainly a huge part of our success. We are in the process of outlining our presentation agenda for 2007.  It takes some time for us to apply for the CME credits and get the credits approved by Rice Memorial Hospital before we can make the brochures and send out this information to all members. If you are interested in presenting or there is someone you would be interested in hearing them speak on a particular topic, please get in touch with us. We would certainly be proud to have ALL speakers members of MRHC.

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The Survey Spot is here!

As we mentioned in our last newsletter, we do a total of eight different patient satisfaction surveys here at the Coop: Emergency Room, Outpatient Services, Same Day Surgery, Home Care – Current, Home Care – Discharged, Acute Care/HCAHPS, Clinic, and our latest addition: Ambulance.
 

The Ambulance survey is a 22-question survey broken down into five different quality indicator areas: arrival time, the ambulance crew, transfer to hospital, if patient was not taken to the hospital, and the overall rating of the ambulance service. Big THANK YOU’s go out to Sue Swan of Murray County Clinic, Kathy Guida of Tyler Healthcare Center, and Gloria Lothert of Redwood Area Hospital, and the unknown others at those facilities who contributed their input into making this instrument what it is.  Twelve facilities are participating in this survey as it has its initial run during the 2^nd & 4^th quarters to see what the results will look like under both cold and warmer climates.

The national implementation of the HCAHPS (Acute Care) survey is getting one step closer. We have gone through the mandatory training and are now a certified survey vendor. The Dry Run, without any public reporting, starts April 1^st and will run for three months before “the real deal” begins in October of this year, with public reporting to first take place in late 2007.  Four of our facilities have chosen us to be their survey vendor in this public reporting initiative:  Chippewa County Montevideo Hospital, Johnson Memorial Health Services, Paynesville Area Health Care Systems, and Redwood Area Hospital. The public reporting process uses the same survey instrument and will receive the same analysis binders as those who didn’t elect to publicly report, but the distribution and data collection processes are much more labor intensive.       

The Home Care Current surveys went out the door in the last couple of weeks, with the Clinic Patient Satisfaction surveys soon to follow.  These surveys marked the first of the surveys to provide benchmarking and in-depth analysis.  Let us know what you think!

The Outpatient Services, Same Day Surgery, and Emergency Room surveys will receive some cosmetic surgery as they will be converted from their simple Yes/No responses over to a 5-point rating system to allow providers the ability to make a distinction between those who agree or not agree with indicator statements.  If you’d like to see any other improvements made to these surveys, we welcome any of your suggestions.

For anyone that knows Sandy that works here at the Coop, there’s not much that wipes the smile off her face. She plays a key role in the processing of all these surveys, so we’d like to make a few suggestions of our own to keep that smile on her face….

1. DON’T make copies of the surveys you receive.  If you need more, give us a call and we’ll send more.  Copies of copies don’t scan in well or not at all, and Sandy doesn’t smile when she has to manually enter all the data from the surveys.

2. If you must write on the surveys to know which site the surveys came from or what provider the patient saw, DON’T write on or near the corner indicator boxes. They don’t scan in, and like I said, Sandy doesn’t smile when she has to manually enter all the data. There’s lots of white space room elsewhere on the surveys to put a couple of initials so leave the boxes alone.

3. DON’T forget to hand out or mail out the surveys once you receive them.  If you don’t distribute them, you are missing out on valuable input from your customers. There is mighty tough competition out there for patients.  You don’t want to lose any of yours by not paying attention to areas where they are unhappy about. Remember the importance of the patient satisfaction surveys: What gets measured gets managed; and what gets managed, gets improved.

4. DON’T forget to distribute ALL the surveys we send you.  Remember that generally there is a 30-45% return rate of surveys from patients. Extremely low numbers of completed surveys will not provide you with an accurate sampling of your patient population to reflect on for improvements.  We are happy to provide the survey service to you as a Coop benefit, but nobody benefits from extremely low numbers.  Therefore, when a facility receives less than 15 completed surveys in a quarter, we won’t be processing an analysis binder for them. Again: What gets measured gets managed; and what gets managed, gets improved. 

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Calling all ye Pharmacists!

If you’d like an up-to-date listing of the pharmacy contracts we have in place and their terms,

the PBM’s we’ve been contacting, PBM contact information, etc., call or e-mail Paula
and provide your e-mail address. She’ll send you an Excel file with all the information.
(320) 564-9118 x12 or psoine@mrhc.net

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Quality Corner - Paula Soine, Quality Manager

Every two years a structured site visit review takes place as part of MRHC’s ongoing quality assurance plan and recredentialing process.  They also are a required facet of our health plan contracts. I conducted them the summer after I was first hired and here it is soon to be that time again! I hop in my car and start my 2-3 month road trip visiting all 25 primary care clinics and the 31 satellite clinics. I can’t think of a better time to conduct the visits than Spring and Summer as I get to watch our beautiful countryside come alive driving from town to town before arriving at the facilities you take such pride in. The site visits include an assessment of each clinic’s physical accessibility and appearance, adequacy of waiting and examining room space, availability of appointments, medication management, medical record keeping practices, written policy review, quality improvement program, and utilization management. In addition to my review of the above criteria, one of the MRHC’s Medical Directors visits the primary care clinics and conducts an audit on 10 to 25 adult and pediatric patient charts, looking at format, content, assessment and plan, follow-up, and preventive care practices. A compliance designation is then determined based on the percentage of each element being present in all records reviewed, and findings are presented to the Credentialing Committee, with a copy sent to each facility. If any Medical Directors are interested in playing a part – many hands make light work - in this process, please get in touch with me soon; your contributions would be appreciated.

The hospital quality contacts have been taking turns giving small presentations on their facility’s quality programs at the quarterly Quality Council meetings. In January we heard from Cheryl Reiniger on Sleepy Eye Medical Center’s CQI program. Cheryl explained that CQI plays a big part in their new employee orientation, explaining to each new member what quality is, how it’s managed, how CQI works, where CQI projects come from, who makes up CQI team members and how each are cross sections of their facility, what their quality strategy is, and what their quality commitments are. We also heard from Lisa Weber on Glencoe Regional Health System’s CQI program. They’ve been using the Toyota Production System (TPS) for over a year now. She explained that hospital staff trained in this methodology for 2 hours a day for 7 weeks, and now they incorporate a “train the trainer” process, using interactive workbooks that help the readers view work differently by applying principles of TPS. Problem solving is done as an experiment, based on the scientific method, and work re-design is done by the resident experts: the people doing the work, under the guidance of a coach who works as a leader/teacher/ facilitator. Work is redesigned toward IDEAL and capacity is increased by reducing waste, without additional technology or staff. At the April 19^th QC meeting, Stella Kalthoff (Swift County-Benson Hospital) will talk about their patient satisfaction survey process, how it differs from the MRHC surveys and what they do with the survey results, and also Rhonda Marcus (Granite Falls Municipal Hospital) will talk about how they handle the annual “Periodic Evaluation and Quality Assurance Review.” There’s always something to learn from somebody else.

The clinic quality contacts will share what they’ve been doing for interventions on their Preventive Services and the new Optimal Diabetes Care QI projects at the April meeting. The Optimal Diabetes Care project was initiated based on results from the 2005 MN Community Measurement Report. Optimal Diabetes Care is an expanded HEDIS diabetes measure based on the ICSI guideline recommendations and used to support improved diabetes care and outcomes and provide performance feedback to medical groups. We’ll be having a representative from the MN Community Measurement organization speaking at the April meeting.

Winners of the 4^th quarter Rewards were: Sue Schneider of Prairie Family Practice (Olivia); Cheryl Reiniger of Sleepy Eye Medical Center; Alicia Jepsen of Hendricks Medical Clinic; and Carol Brinkman of Williams IntegraCare Clinic (Sartell). I found it interesting that 18 of the 25 primary care clinics (72%) have been winners at least once since we started this two years ago. Four clinics have only won one time; seven have won two times; three have won three times; and four have won four times now! THANKS AGAIN for all you do.

Quality is Everybody’s Responsibility